Bullying can take many forms from physical violence, to verbal insults, spreading rumours and excluding people from activities. It takes a physical and emotional toll on victims, the effects of which can persist after the bullying itself stops.

Surveys in the UK indicate that up to half of primary school pupils and one in 10 secondary school students have been bullied (Royal College of Psychiatrists).

The proliferation of social media and other forms of communication, such as texting, have created a new medium for bullying, which is termed “cyberbullying”. It is estimated that around 38% of young people have experienced cyberbullying (NSPCC).

A new survey by North American researchers, published in JAMA Pediatrics, sought to identify the association of cyberbullying with mental health and substance misuse. Additionally authors sought to determine the protective effect of family support, in particular through family meals, for young people exposed to cyberbullying.

The UK government estimates that just over 1 in 3 young people have experienced cyberbullying (Source: NSPCC).

Methods

The survey was distributed electronically to 20,385 young people in 49 middle- and high-schools in a Mid-Western US state. Participation was voluntary and anonymous. Parents were informed about the survey 4 weeks in advance so that they could review the survey and could opt out. The survey response rate was high, with 90% of students in most districts participating.

The survey measured:

The frequency of cyberbullying and “traditional” face-to-face bullying victimisation

“Internalising” problems: anxiety, depression, self-harm and suicide attempt in the past 12 months, and suicidal thoughts in the past 30 day

“Externalising” problems: physical fighting or vandalising property in the past 30 days

Substance use problems that may represent coping mechanisms: ≥3 episodes of drunkenness or binge drinking in the previous 30 days, prescription or over-the-counter (OTC) drug misuse in the previous 12 months

The number of times evening meals were eaten with their family

Demographic information about respondents’ age, sex and eligibility for free or reduced-cost school meals (indicating low income households)

Ordinal regression was used to analyse the contribution of demographic factors to cyberbullying victimisation. Odd ratios (ORs) were calculated using logistic regression to examine the association between mental health and substance abuse with cyberbullying exposure. Negative binomial regressions were used to test the direct and indirect effects of cyberbullying victimisation and family dinners on internalising and externalising problems, alcohol and substance misuse and health problems.

The explosion in technology and social media make cyberbullying an easy offense to commit.

Results

The final sample included 18,834 participants. 1,551 cases were excluded where complete cyberbullying data was unavailable. Compared with the remaining sample, excluded cases were slightly older (15.3 vs 15.0 years; p=<0.001), included fewer girls (35.9% vs 50.5%; p=<0.001) and included fewer low-income students (10.1% vs 19.2%, p=<0.001). The removal of these cases did not affect the overall demographic of the final sample. Due to technical problems, the drunkenness and binge drinking questions were only administered to 6,454 students, but this subsample did not differ from the remaining sample on demographics.

6% of respondents had experienced cyberbullying in the past 12 months

Cyberbullying incidence was:

More common in girls (OR 2.95, 95% Confidence Interval 2.54 to 3.44)

Increased with every additional year of age (OR 1.07, 95% CI 1.03 to 1.11)

Increased by involvement in traditional face-to-face bullying:

As a target (OR 1.37, 95% CI 1.33 to 1.40)

As the perpetrator (OR 1.12, 95% CI 1.08 to 1.16)

The OR for all outcomes relating to mental health problems, alcohol and substance misuse, self-harm, and suicidal thoughts and suicide attempts increased as the frequency of cyberbullying increased. These associations persisted even when analyses were adjusted to control for the co-occurrence of face-to-face bullying

Family dinners were negatively related to the frequency of cyberbullying and all health outcomes, this association was strengthened as cyberbullying became more frequent

The survey reported that 6% of adolescent respondents had experienced cyberbullying in the last year.

Conclusions

The authors concluded that:

Cyberbullying uniquely relates to internalizing, externalizing, and substance use problems in adolescents. The associations are not explained by involvement in traditional (face-to-face) forms of bullying. However, their strength is moderated by the frequency of family dinners.

Health care professionals should be aware of the potential health risks associated with cyberbullying and the benefits associated with regular and frequent family contact.

Further study is needed to identify other paths through which social support can protect adolescents from the risks associated with online bullying.

Summary

This large survey provides data on the amount of cyberbullying that takes place, its relationship to “traditional” face-to-face bullying and demonstrates the various negative effects that cyberbullying has on its targets.

Authors acknowledge the limitations of the survey, especially regarding some of the measurements used and that they were not able to detect potential underreporting of cyberbullying amongst boys.

The health impact of cyberbullying persisted even when it was controlled for co-occurrence of “traditional” bullying, therefore authors suggest cyberbullying is a worthwhile target for preventive interventions.

Family dinners provide an opportunity for interaction, but are likely part of a wider set of family characteristics which are conducive to creating an environment that has a positive effect on young people’s overall mental health.

As this was a survey, it cannot conclusively say that its findings prove a causative link, but it nonetheless provides interesting findings and directions for further research.

Many readers will be unsurprised to hear that the family contact and communication typical at shared mealtimes are beneficial to adolescent mental health, and may help protect young people from the harms of cyberbullying.

Bullying can potentially be a contributory factor in suicide, but it is unlikely to be the sole cause

Witnesses and perpetrators are also affected by bullying, as well as those who are the targets of bullying

Criminalising bullying may not help and efforts should be concentrated on dealing with and preventing bullying

Support if you are experiencing cyberbullying

The NSPCC and Royal College of Psychiatrists provide advice to parents on how they can encourage their child to talk to them about cyberbullying. Chatdanger and NHS Choices provide information on how to prevent and respond to cyberbullying. Childline and the NSPCC provide 24 hour telephone advice lines that parents and young people can use to get advice about cyberbullying.

If you need help

If you need help and support now and you live in the UK or the Republic of Ireland, please call the Samaritans on 116 123.

Elly is an Information Specialist, specialising in healthcare. Mental health is a particular area of interest, having worked on a range of mental health related projects. Elly is interested in communicating and explaining mental health research to a wider audience.

I had a very interesting and sensible conversation with my 10 year old son re all areas of bullying. He can’t understand why people being bullied on the Internet don’t just switch it off! He also can’t undersatnd parents of children under 16 allowing access to social media. But most telling was he can’t undersrand why children are so soft, he tells me “mum we all have a laugh at each other and sometimes it can be awful, but that’s kids for you!” I am glad he understands why we set Internet rules re social media. I am with him as to why parents allow access when their children are under the required age! Yes cyber bullying must be awful but there is a very issue solution as my 10 year old said just switch it off.

Bullying and Cyberbullying are one of the biggest causes of mental health issues in children and young adults and it is heartbreaking. Sometimes people don’t realise the full consequence of their words and sometimes they do. While bullying is talked about so much in schools, actually stopping it from happening is harder, it seems to be human nature. And once it’s started, the effects on the bullied persons mental health have already started. There needs to be more support for those being bullied and much more help for their future mental health state.